This paper studies trauma services available in Maryland and locally, in Silver Spring. It describes the structure and components of the system, presents the assistance offered at different levels of care, and indicates its strengths and weaknesses. The paper also estimates the degree of disaster preparedness of the local trauma system based on its capability to manage major incidents and studies the available sources of additional aid.
Trauma Services in Maryland
Maryland Institute for Emergency Medical Service Systems (n.d.) presents several local centers providing trauma services. The R. Adams Cowley Shock Trauma Center of the University of Maryland Medical System serves as a primary adult resource center. The Johns Hopkins Children’s Center (Baltimore City) is the center for pediatric trauma care. The Johns Hopkins Hospital also provides services for level I and level II trauma patients.
Level II trauma centers include Prince George’s Hospital Center (Cheverly), Sinai Hospital of Baltimore (Baltimore City), and Suburban Hospital (Bethesda). Meritus Medical Center (Hagerstown), Maryland Regional Medical Center (Cumberland), and Peninsula Regional Medical Center (Salisbury) provide level III trauma care. The closest centers available in my area are in Bethesda and Cheverly.
Structure and Components of the Trauma System
According to Soto, Zhang, Huang, and Feng (2018), the staff of Emergency Medical Services is the initial source of care for injured patients. After the assessment, the patients are referred to the hospital medical professionals that provide care according to the level of trauma. For example, in Maryland, institutions of all levels have resuscitation units, operating rooms, and intensive care units available at all times (Maryland Institute for Emergency Medical Service Systems, n.d.).
The assistance of trauma surgeons is offered at any time in levels I and II facilities and within 30 minutes of call for the patients requiring level III care, including on-call neurosurgeons in levels I and II. Anesthesiologists at all times are available in the level I and II care institutions but are shared with other services, and there are on-call professionals for level III traumas.
Strengths and Weaknesses of Trauma Care Systems
The research by Brown, Rosengart, Billiar, Peitzman, and Sperry (2016) states that Maryland has a relatively low injury fatality rate (up to 53 per 100,000 population). It means that the emergency medical services systems (EMSS) are effective in providing trauma care. The primary strength of EMSS in Maryland is that all medical professionals that are usually involved in trauma care are available either at all times or within 30 minutes of call. The main weakness of Maryland EMSS is that the state does not have maximized placement of trauma centers, which can be proven by the little number of available institutions (Brown et al., 2016). For example, people living in smaller cities have to be transferred to other locations to receive help, which may require 15 minutes to 2 hours.
Disaster Preparedness Estimation
In my opinion, the level of disaster preparedness of my local trauma system is moderate. For example, level III care is only provided in Hagerstown, Cumberland, and Salisbury; those medical centers are far from Silver Spring. The institutions in Bethesda and Cheverly only offer level II care; however, such assistance can be sufficient for the majority of injured people if an incident occurs. The closest available assets of additional aid are the George Washington University Hospital and other medical institutions in Washington, DC. I believe that in case of a disaster, local EMSS will require their assistance to avoid the lack of staff and care for patients.
Conclusion
The trauma services available in Maryland and Silver Spring are limited. The care is provided at all times or within 30 minutes of call, but only three institutions in the state offer assistance to level III patients. It means that in case of a major incident it may be reasonable to use the assets of Washington, DC to ensure that individuals have access to necessary treatment.
References
Brown, J. B., Rosengart, M. R., Billiar, T. R., Peitzman, A. B., & Sperry, J. L. (2016). Geographic distribution of trauma centers and injury related mortality in the United States. The Journal of Trauma and Acute Care Surgery, 80(1), 42–50.
Maryland Institute for Emergency Medical Service Systems (n.d.). Web.
Soto, J. M., Zhang, Y., Huang, J. H., & Feng, D. X. (2018). An overview of the American trauma system. Chinese Journal of Traumatology, 21(2), 77–79.